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https://www.readbyqxmd.com/read/28724126/comparative-outcomes-after-percutaneous-coronary-intervention-among-black-and-white-patients-treated-at-us-veterans-affairs-hospitals
#1
Taisei Kobayashi, Thomas J Glorioso, Ehrin J Armstrong, Thomas M Maddox, Mary E Plomondon, Gary K Grunwald, Steven M Bradley, Thomas T Tsai, Stephen W Waldo, Sunil V Rao, Subhash Banerjee, Brahmajee K Nallamothu, Deepak L Bhatt, A Garvey Rene, Robert L Wilensky, Peter W Groeneveld, Jay Giri
Importance: Current comparative outcomes among black and white patients treated with percutaneous coronary intervention (PCI) in the Veterans Affairs (VA) health system are not known. Objective: To compare outcomes between black and white patients undergoing PCI in the VA health system. Design, Setting, and Participants: This study compared black and white patients who underwent PCI between October 1, 2007, and September 30, 2013, at 63 VA hospitals using data recorded in the VA Clinical Assessment, Reporting, and Tracking System for Cardiac Catheterization Laboratories (CART-CL) program...
July 19, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28718889/veno-arterial-extracorporeal-membrane-oxygenation-support-in-patients-undergoing-aortic-surgery
#2
Zhaopeng Zhong, Chunjing Jiang, Feng Yang, Xing Hao, Jialin Xing, Hong Wang, Xiaotong Hou
Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is an option for mechanical support for patients with postcardiotomy cardiogenic shock (PCS). However, the use of VA-ECMO in patients suffering from aortic disease with PCS has not been greatly reported. This is a retrospective review of adult patients undergoing aortic surgery who received VA-ECMO support to treat refractory PCS from August 2009 to May 2016. A total of 36 patients who underwent aortic surgery with VA-ECMO support for refractory PCS were included...
July 18, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28716039/extra-corporeal-membrane-oxygenation-for-refractory-cardiogenic-shock-after-adult-cardiac-surgery-a-systematic-review-and-meta-analysis
#3
Maziar Khorsandi, Scott Dougherty, Omar Bouamra, Vasudev Pai, Philip Curry, Steven Tsui, Stephen Clark, Stephen Westaby, Nawwar Al-Attar, Vipin Zamvar
BACKGROUND: Postcardiotomy cardiogenic shock (PCCS) refractory to inotropic support and intra-aortic balloon pump (IABP) occurs rarely but is almost universally fatal without mechanical circulatory support. In this systematic review and meta-analysis we looked at the evidence behind the use of veno-arterial extra-corporeal membrane oxygenation (VA ECMO) in refractory PCCS from a patient survival rate and determinants of outcome viewpoint. METHODS: A systematic review was performed in January 2017 using PubMed (with no defined time period) using the keywords "postcardiotomy", "cardiogenic shock", "extracorporeal membrane oxygenation" and "cardiac surgery"...
July 17, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28709785/implementing-and-evaluating-a-telephone-based-centralized-maternity-care-coordination-program-for-pregnant-veterans-in%C3%A2-the-department-of-veterans-affairs
#4
Kristin M Mattocks, Judy Kuzdeba, Rebecca Baldor, Jose Casares, Lisa Lombardini, Megan R Gerber
PURPOSE: The purpose of this study was to develop and evaluate a comprehensive, telephonic maternity care coordination (MCC) program for all pregnant veterans enrolled for care at New England Department of Veterans Affairs (VA) facilities that comprise the Veterans Integrated Service Network 1. RESEARCH DESIGN: Telephone interviews were conducted with postpartum women veterans who had participated in the MCC program during their pregnancies. The program evaluation instrument assessed satisfaction and use of MCC services, prenatal education classes, and infant and maternal outcomes (e...
July 11, 2017: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
https://www.readbyqxmd.com/read/28700475/association-of-ventricular-arrhythmia-and-in-hospital-mortality-in-stroke-patients-in-florida-a-nonconcurrent-prospective-study
#5
Arielle A Dahlin, Chase C Parsons, Noël C Barengo, Juan Gabriel Ruiz, Melissa Ward-Peterson, Juan Carlos Zevallos
Stroke remains one of the leading causes of death in the United States. Current evidence identified electrocardiographic abnormalities and cardiac arrhythmias in 50% of patients with an acute stroke. The purpose of this study was to assess whether the presence of ventricular arrhythmia (VA) in adult patients hospitalized in Florida with acute stroke increased the risk of in-hospital mortality.Secondary data analysis of 215,150 patients with ischemic and hemorrhagic stroke hospitalized in the state of Florida collected by the Florida Agency for Healthcare Administration from 2008 to 2012...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28692402/enhanced-influenza-surveillance-using-telephone-triage-and-electronic-syndromic-surveillance-in-the-department-of-veterans-affairs-2011-2015
#6
Cynthia Lucero-Obusan, Carla A Winston, Patricia L Schirmer, Gina Oda, Mark Holodniy
Telephone triage (TT) is a method whereby medical professionals speak by telephone to patients to assess their symptoms or health concerns and offer advice. These services are often administered through an electronic TT system, which guides TT professionals during the encounter through the use of structured protocols and algorithms to help determine the severity of the patients' health issue and refer them to appropriate care. TT is also an emerging data source for public health surveillance of infectious and noninfectious diseases, including influenza...
July 2017: Public Health Reports
https://www.readbyqxmd.com/read/28691503/improving-transitions-of-care-for-veterans-transferred-to-tertiary-va-medical-centers
#7
Robert E Burke, Lynette Kelley, Elise Gunzburger, Gary Grunwald, Madhura Gokhale, Mary E Plomondon, P Michael Ho
Veterans are often transferred from "spoke" Veterans Administration (VA) clinics or hospitals to "hub" tertiary VA hospitals for advanced inpatient care, but they face significant barriers to safe transitions home. The Transitions Nurse Program was developed as an intervention to address the unique needs of this population. A difference-in-differences (DiD) analysis was used to compare outcomes between 303 veterans enrolled in this program and veterans transferred from the same spoke sites to a second, similar tertiary VA hub...
July 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/28673618/extracorporeal-membrane-oxygenation-and-interfacility-transfer-a-regional-referral-experience
#8
David N Ranney, Desiree Bonadonna, Babatunde A Yerokun, Michael S Mulvihill, Nawar Al-Rawas, Michael Weykamp, Rathnayaka M Gunasingha, Raquel R Bartz, John C Haney, Mani A Daneshmand
BACKGROUND: The number of adults referred to high-volume centers for extracorporeal membrane oxygenation (ECMO) is increasing. Outcomes of patients requiring transport are not well characterized, and referral guidelines are lacking. This study describes the experience and outcomes of a single high-volume center. METHODS: A retrospective study was performed that included adults undergoing ECMO between June 2009 and December 2015. Patient characteristics and outcomes were acquired from the medical record...
June 30, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28665744/if-we-don-t-ask-our-patients-might-never-tell-the-impact-of-the-routine-use-of-a-patient-values-assessment
#9
J Russell Hoverman, Cynthia Taniguchi, Kathryn Eagye, Sabrina Mikan, Angela Kalisiak, Susan Ash-Lee, Rhonda Henschel
PURPOSE: Good communication can be associated with better end-of-life outcomes. The US Oncology Network developed and tested a Values Assessment (VA) for facilitating advance care planning (ACP). The results of the first 1,268 patients are reported. METHODS: The VA consists of 10 questions of the format "How valuable is it to me to…" (eg, "...know that I am not a burden to my family, friends, or helpers?"). Responses were on a four-point scale from unsure to very valuable...
June 30, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28662862/the-use-of-rigid-gas-permeable-contact-lenses-in-children-with-myopic-amblyopia-a-case-series
#10
Bingjie Wang, Rajeev K Naidu, Xiaomei Qu
PURPOSE: To explore the safety profile and overall visual improvement over the course of RGP contact lens wear on children with unilateral or bilateral amblyopia resulting from myopia. METHODS: This was a retrospective analysis case series study. Clinical records of 15 patients who were fitted with RGP contact lenses at the Shanghai Eye and EENT Hospital of Fudan University between the period of January 2009 to December 2014 were reviewed. The inclusion criteria for review included patients with myopia of -3...
June 26, 2017: Contact Lens & Anterior Eye: the Journal of the British Contact Lens Association
https://www.readbyqxmd.com/read/28645479/impact-of-the-nap-1-strain-on-disease-severity-mortality-and-recurrence-of-healthcare-associated-clostridium-difficile-infection
#11
Karri A Bauer, Jessica E W Johnston, Eric Wenzler, Debra A Goff, Charles H Cook, Joan-Miquel Balada-Llasat, Preeti Pancholi, Julie E Mangino
OBJECTIVES: Studies are conflicting regarding the association of the North American pulsed-field gel electrophoresis type 1 (NAP1) strain in Clostridium difficile infection (CDI) and outcomes. We evaluated the association of NAP1 with healthcare-associated CDI disease severity, mortality, and recurrence at our academic medical center. METHODS: Healthcare-associated CDI cases were identified from November 1, 2011 through January 31, 2013. Multivariable regression models were used to evaluate the associations of NAP1 with severe disease (based on the Hines VA severity score index), mortality, and recurrence...
June 21, 2017: Anaerobe
https://www.readbyqxmd.com/read/28643322/difficulties-in-funding-of-va-ecmo-therapy-for-patients-with-severe-accidental-hypothermia
#12
Sylweriusz Kosiński, Tomasz Darocha, Anna Jarosz, Aleksandra Czerw, Paweł Podsiadło, Tomasz Sanak, Robert Gałązkowski, Jacek Piątek, Janusz Konstanty-Kalandyk, Mirosław Ziętkiewicz, Krzysztof Kusza, Łukasz J Krzych, Rafał Drwiła
BACKGROUND: Severe accidental hypothermia is defined as a core temperature below 28 Celsius degrees. Within the last years, the issue of accidental hypothermia and accompanying cardiac arrest has been broadly discussed and European Resuscitation Council (ERC) Guidelines underline the importance of Extracorporeal Rewarming (ECR) in treatment of severely hypothermic victims. The study aimed to evaluate the actual costs of ECR with VA-ECMO and of further management in the Intensive Care Unit of patients admitted to the Severe Accidental Hypothermia Centre in Cracow, Poland...
2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28641586/access-education-and-policy-awareness-predictors-of-influenza-vaccine-acceptance-among-vha-healthcare-workers
#13
Jennifer Lipkowitz Eaton, David C Mohr, Kathleen M McPhaul, Richard A Kaslow, Richard A Martinello
OBJECTIVE To identify predictors of influenza vaccine acceptance among VHA healthcare workers (HCWs), with emphasis on modifiable factors related to promotion campaigns. DESIGN Survey. SETTING National single-payer healthcare system with 140 hospitals and 321,000 HCWs. PARTICIPANTS National voluntary sample of HCWs in the Veterans Health Administration (VHA) system. METHODS We invited a random sample of 5% of all VHA HCWs to participate. An 18-item intranet-based survey inquired about occupation, vaccination status, employer policy, and local campaign efforts...
June 23, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28637497/influence-of-low-flow-time-on-survival-after-extracorporeal-cardiopulmonary-resuscitation-ecpr
#14
Tobias Wengenmayer, Stephan Rombach, Florian Ramshorn, Paul Biever, Christoph Bode, Daniel Duerschmied, Dawid L Staudacher
BACKGROUND: Venoarterial extracorporeal membrane oxygenation (VA-ECMO) support under extracorporeal cardiopulmonary resuscitation (eCPR) is the last option and may be offered to selected patients. Several factors predict outcome in these patients, including initial heart rhythm, comorbidities, and bystander cardiopulmonary resuscitation (CPR). We evaluated outcomes of all VA-ECMO patients treated within the last 5 years at our center in respect to low-flow duration during CPR. METHODS: We report retrospective registry data on all patients with eCPR treated at a university hospital between October 2010 and May 2016...
June 22, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28631639/prevalence-of-clostridium-difficile-infection-among-the-patients-attending-a-tertiary-care-teaching-hospital
#15
Lavanya Segar, Joshy M Easow, Sreenivasan Srirangaraj, Mohammad Hanifah, Noyal M Joseph, K S Seetha
BACKGROUND: Clostridium difficile, a most important nosocomial enteric pathogen, is recognized globally as responsible for antibiotic-associated diarrhea and colitis. It is associated with considerable morbidity and mortality due to widespread use of antibiotics. AIMS: The study was done to determine the prevalence of C. difficile infection (CDI) among the patients attending a tertiary care teaching hospital in Puducherry. SETTINGS AND DESIGN: We performed a prospective cohort study in Mahatma Gandhi Medical College and Research Institute...
April 2017: Indian Journal of Pathology & Microbiology
https://www.readbyqxmd.com/read/28624360/association-between-arterial-access-site-and-anticoagulation-strategy-on-major-bleeding-and-mortality-a-historical-cohort-analysis-in-the-veteran-population
#16
Jayant Bagai, Bert Little, Subhash Banerjee
BACKGROUND: Studies have shown reduction in major bleeding with trans-radial intervention (TRI) compared with trans-femoral intervention (TFI), and with use of bivalirudin compared with heparin+glycoprotein IIb/IIIa inhibitors (GPI). We compared major bleeding, mortality and the interaction between arterial access site and the anticoagulant used for PCI in Veterans. METHODS: A retrospective cohort of 1192 consecutive patients who underwent PCI at a VA hospital between 2006 and 2012 was divided into TFI-heparin (n=192), TFI-bivalirudin (n=272), TRI-heparin (n=274) and TRI-bivalirudin (n=454) groups...
June 8, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28623113/does-robotic-surgical-simulator-performance-correlate-with-surgical-skill
#17
James T Mills, Helen Y Hougen, Daniel Bitner, Tracey L Krupski, Noah S Schenkman
OBJECTIVE: To assess the relationship between robotic surgical simulation performance and the real-life surgical skill of attending surgeons. We hypothesized that simulation performance would not correlate with real-life robotic surgical skill in attending surgeons. DESIGN: In 2013, Birkmeyer et al. demonstrated an association between laparoscopic surgical performance as determined by expert review of video clips and surgical outcomes. Using that model of expert review, we studied the relationship between robotic simulator performance and real-life surgical skill...
June 13, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28622819/systematic-and-organizational-issues-implicated-in-post-hospitalization-suicides-of-medically-hospitalized-patients-a-study-of-root-cause-analysis-reports
#18
Natalie Riblet, Brian Shiner, Peter Mills, Brett Rusch, Robin Hemphill, Bradley V Watts
OBJECTIVE: Medical hospitalization is a high risk period for suicide. It is important to understand system-level factors that may be associated with suicide after a medical hospitalization. METHOD: Retrospective study of root-cause analysis (RCA) reports of suicide occurring within three months of Veterans Administration (VA) medical hospitalization, 2002-2015. We collected patient and system-level factors to characterize events. RESULTS: There were 96 RCA reports pertaining to suicide within three months of medical hospitalization...
May 2017: General Hospital Psychiatry
https://www.readbyqxmd.com/read/28618875/implementation-of-guideline-based-therapy-for-chronic-obstructive-pulmonary-disease-differences-between-men-and-women-veterans
#19
Seppo T Rinne, A Rani Elwy, Chuan-Fen Liu, Renda Soylemez Wiener, Lisa Thayer, Alexandra Gerity, Lori A Bastian
Chronic obstructive pulmonary disease (COPD) is common among both men and women, and guidelines recommend the same therapy for both sexes. While previous studies have identified gender differences in other chronic disease management, few studies have examined how implementation of COPD guidelines differs between men and women. We performed a cross-sectional study of veterans admitted to Veterans Affairs (VA) hospitals for COPD during October 1, 2008, to September 30, 2011. We collected information on baseline COPD medications during the 6 months prior to hospitalization and categorized therapies as "appropriate" or "inappropriate" based on current guidelines...
January 1, 2017: Chronic Respiratory Disease
https://www.readbyqxmd.com/read/28605268/va-staff-perceptions-of-the-role-of-the-extended-care-referral-process-in-home-and-community-based-services-versus-nursing-home-use-posthospital-discharge
#20
Edward Alan Miller, Orna Intrator, Emily Gadbois, Stefanie Gidmark, James L Rudolph
Little is known about how the extended care referral process-its structure and participants-influences Veterans' use of home and community-based services (HCBS) over nursing home care within the Veterans Health Administration (VHA). This study thus characterizes the extended care referral process within the VHA and its impact on HCBS versus nursing home use at hospital discharge. Data derive from 35 semistructured interviews at 12 Veterans Affairs Medical Centers (VAMCs). Findings indicate that the referral process is characterized by a commitment by care teams to consider HCBS if possible, varied practice depending on the clinician that most heavily influences care team recommendations, and care team emphasis on respecting Veteran/family preferences even when they are contrary to care team recommendations...
June 12, 2017: Home Health Care Services Quarterly
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